The Voice News | As House Republicans move forward with a proposal to slash hundreds of billions from Medicaid, a political irony has emerged: the cuts will disproportionately harm working-class voters—especially in Trump strongholds—who helped secure Donald Trump’s victory in 2024. The contradiction exposes the fragile facade of Trump’s claim to be building a “working-class Republican Party.” The newrepublic.com has published a news on this regard.
Strikingly, one of the strongest early critics of such Medicaid cuts was JD Vance, now Trump’s Vice President. Before his full embrace of MAGA politics, Vance repeatedly warned that Republican attempts to gut Medicaid would betray the very voters Trump claimed to champion.
Back in 2017, as House Republicans sought to repeal the Affordable Care Act (ACA) and phase out Medicaid expansion, Vance—then a rising conservative voice and author of Hillbilly Elegy—condemned the proposal. He argued that Trump had gained working-class trust precisely because he didn’t threaten to cut programs like Social Security and Medicaid, unlike traditional Republicans.
In an interview with the Cleveland Plain Dealer, Vance asserted that the GOP bill undermined Trump’s supposed populist agenda. In a New York Times op-ed that same year, he warned that shifting millions from Medicaid to the private market would strip them of meaningful healthcare access, calling instead for a “baseline provision of care” for working-class Americans.
But today, Vance’s past principles are running headlong into political reality. The House GOP’s latest Medicaid plan includes work requirements and bureaucratic barriers that experts say would remove at least 7 million people from the program—many of them working poor in red states.
These proposals echo the failed 2017 repeal effort and, again, threaten those Vance once defended: low-income workers, many with chronic conditions, who lack access to private insurance. According to Robin Rudowitz of health policy nonprofit KFF, these are exactly the populations being targeted now.
So what changed?
Over the past few years, Vance has undergone a dramatic transformation. Once a Trump skeptic, he evolved into a MAGA loyalist, culminating in his vice-presidential nomination. But the costs of that transformation are now clear. His early condemnation of Medicaid cuts wasn’t a personal critique of Trump’s temperament; it was a challenge to the GOP’s policy priorities. Now, as part of the Trump ticket, he appears poised to back those very same policies.
The deeper truth, critics argue, is that Trumpism was never truly populist in the economic sense. While Trump claimed to champion working-class interests, his policies often undermined them. Scholars like John Ganz and Matt McManus argue that Trumpism’s core isn’t about economic empowerment, but about social hierarchy—dividing the nation into MAGA “winners” and everyone else.
This ideological foundation explains why massive Medicaid cuts—despite hurting Trump voters—fit neatly within Trump-era GOP politics. Vance once believed that conservative populism required a robust safety net. But as he ascended within MAGA ranks, he embraced its culture wars, grievances, and selective authoritarianism—while quietly abandoning the social protections he once championed.
There is still a chance, however faint, that Vance and Trump will oppose the proposed cuts. Trump has privately told lawmakers to avoid cuts beyond targeting “waste, fraud, and abuse,” while simultaneously endorsing “commonsense work requirements”—a phrase often used to justify policies that significantly reduce Medicaid enrollment.
Ultimately, Vance’s current stance will reveal whether his past criticisms were rooted in genuine concern or mere political positioning. If he endorses a plan that guts Medicaid for millions of struggling Americans, he won’t just be reversing his own record—he’ll be exposing the performative populism at the heart of modern Trumpism.